I saw that, plus the Forbes article that tried to spin it the other way. Yet in the end, patients who are dying are going to go for the most effective medication they can, especially when it has already been proven both safe and effective.

Amgen's PCSK9 inhibitor works through a different mechanism to help patients with a rare genetic disease that causes extremely high levels of cholesterol. For some patients, the drug, dubbed AMG 145, will have better safety profile, unlike Lomitapide with patient die with fatty livers.

"PCSK9 binds to the epidermal growth factor-like repeat A (EGF-A) domain of the low-density lipoprotein receptor (LDLR), inducing LDLR degradation. Reduced LDLR levels result in decreased metabolism of low-density lipoproteins, which could lead to hypercholesterolemia"
PCSK9 inhibitor reverse the process...

for Lomitapide, it inhibits the microsomal triglyceride transfer protein (MTP or MTTP) ) which is necessary for very low-density lipoprotein (VLDL) assembly and secretion in the liver (fatty liver)...

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